Statistical Analysis, Often Performed on National Board Exams, May Result in Accusations of "Irregular Behavior" or Other Career-Killing Charges

Tuesday, May 13, 2014
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Before obtaining a professional license or degree, medical, dental, chiropractic and other professional students are subject to stringent testing.  Students must take and pass the national board examinations. These examinations are usually administered by private companies, such as the National Board of Medical Examiners (NBME), through the United States Medical Licensing Examination (USMLE) program, the National Board of Dental Examiners (NBDE), the National Board of Chiropractic Examiners (NBCE), or other organizations.  Graduates of foreign medical schools and other foreign professional colleges are usually required to take and pass the same examinations as the graduates of U.S. medical schools, before they can be licensed.  For medical students, these may be coordinated through the Examination Committee for Foreign Medical Graduates (ECFMG).

An Adverse Finding by a National Testing Board Can Ruin A Medical Career Before it Starts.

Recently we have been consulted by medical school students, dental school students, chiropractic school students and foreign medical school graduates accused of "irregular behavior," "anomalous behavior," "obtaining an unfair advantage, or cheating. These accusations of improper test taking can be defined as cheating, attempting to gain an unfair advantage on an examination or other questionable conduct that appears to be an attempt to subvert the examination process.

I have written several blogs on these issues. It is important to obtain a hearing and avail oneself of your legal rights in such matters. Click here to read my first blog. Click here to read my second blog.

Statistical Analysis Can Lead to Accusation of Irregular Behavior.

Lately, we have seen more cases where a statistical analysis of the student's examination has been conducted by the testing organization. A statistical analysis may also be called an analysis of the "psychometric integrity" of the examination by the NBCE. These analyses have led to accusations of irregular behavior or questionable conduct.

The USMLE Bulletin of Information states, for example:

"If information received suggests that irregular behavior has occurred, statistical analyses may be conducted and additional information may be gathered."

Click here to read the
USMLE Bulletin.

The USMLE Bulletin of Information states the following regarding "anomalous performance" on its examinations (page 37):

"Anomalous performance and/or unusual testing history may be indicative of irregular behavior or other issues that bear on your access to USMLE. If your performance raises concerns about your readiness to test or your motivation to pass, the USMLE program reserves the right to restrict your future access to its examinations and/or to impose conditions upon future access. . . .  Taking a Step administration to familiarize yourself with the examination format, or for any reason other than to pass, may result in a limitation being placed on your future access to USMLE."

Thus the anomalous behavior label could apply to either an unusually high score or, more likely, an unusually low score. Sometimes the statistical analysis shows that two applicants have substantially similar responses (both correct and incorrect answers). This can also lead to investigations and cheating allegations.

The Importance of Retaining Experienced Legal Defense.

When we represent an applicant accused of such matters, we request the complete, detailed report of analysis and have our own statistics expert review it.  You may often find errors in the actual statistical analysis performed.  This is only one of the many ways we defend those who may be charged with conduct that may adversely damage their career. Click here to read more.

Reference Articles.

A few articles that contain interesting information on statistical analyses of various national board exams, which may also yield the names of expert witnesses an individual can use to defend himself in such a case, follow:

5. (Summary of article)
6.  (Full article)
7.  (Full article)

Contact Experienced Health Law Attorneys Today.

The Health Law Firm attorneys represent medical, dental, chiropractic, other professional students, residents, interns and fellows. We provide our legal services in academic disputes, graduate medical education (GME) hearings, contract negotiations, license applications, board certification applications and hearings, credential hearings, and civil and administrative litigations.
To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at


Have you ever been accused of irregular behavior? Please leave any thoughtful comments below.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law.  He is the President and Managing Partner of The Health Law Firm, which has a national practice.  Its main office is in the Orlando, Florida, area.  The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone:  (407) 331-6620.

Tag Words: National Board of Medical Examiners (NBME), medical students, medical resident, irregular behavior, United States Medical Licensing Examination (USMLE), Examination Committee for Foreign Medical Graduates (ECFMG), cheating, USMLE preparation course , USMLE hearings , USMLE appeals, defense attorney, defense lawyer, statistical analysis, National Board of Dental Examiners, NBDE, National Board of Chiropractic Examiners, NBCE, legal representation, health care attorney, health care lawyer, medical student lawyer, medical student attorney, medical resident lawyer, medical resident attorney, medical intern lawyer, medical intern attorney, civil proceeding, criminal proceeding, administrative proceeding, medical administrative hearings, administrative law, The Health Law Firm, defense attorney, defense lawyer

The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
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